projecteverest

Community Health Hub

by
Dolly Phiri
Dolly Phiri | Jul 28, 2017 | in Health Consulting

Hi all,

Over the month of July, the Malawi health assessment team uncovered multiple issues in the Blantyre. The major issue was access, especially to education and health services. This meant that the people heavily depended on the health care system and would go to the doctor for minor illnesses that would normally be treated at home in western countries, such as the common cold. Transport costs were also a barrier and people would have to walk long distances in order to reach a health facility.

In line with the innovative ideas on this platform, I would like to share my idea with the PE community – to receive opinions and feedback. My potential solution is a self-testing app situated in a community hub for convenience.

 

WHY

There is a lack of access to healthcare services especially in the remote villages. The health assessment team’s surveys found that many villagers were travelling an average of 2.5hrs per day to reach a health facility. There is also a lack of education in regard to illness causes and prevention. This means people go to the doctor even when they have muscle aches because they have been working long hours. They do not know that these pains were caused by their physical work and can be treated at home by rest and light exercise.

There is also a low percentage of the population that has smartphones so a communal base to share the technology would be beneficial to individuals in the initial phases of the business model, whereas in the long-run, when they are able to increase their expendable incomes, they can purchase smartphones and access the service from their homes. The agriculture and social consulting assessment will help people improve their incomes by facilitating sustainable farming and micro-financing. Their assessment will enable people will be able to grow more crop and receive a greater profit when they yield the crop.

 

WHAT

The hub would be situated in the middle of the village where it can easily be accessed by everyone from the village 24hrs a day. This hub would be fitted with tablets (into the benches in the same style as Telecom stores) that have a diagnostic app connected to local doctors of differing specialisations. This app would be in the local language to enable locals to use them independently.

The hub would also have an attendant that can assist people use the technology and provide over-the-counter medication if need be.

The individuals in the community currently pay MWK400 return to get to a health facility. They would be saving this money by paying a lower fee to use the hub. This is more efficient because they are also saving time in travel and are able to spend more time working to make an income rather than wasting a whole day seeking medical aid.

 

HOW

People would enter their symptoms and the app would diagnose the illness. If the illness needs further medical attention, it will notify the doctor best suited to the condition and the patient will be referred to their facility. If the app does not suggest further medical attention, the hub will have medicine stocked and they will be notified on what medication to use, the dosages and what the side effects may be. This app would save the details of the patient so that when they revisit, it is aware of their existing conditions and any allergies they might have.

This ideas is in it’s preliminary stages and I would really appreciate some insights and ideas from everyone if this is a viable solution in Malawi or how it can be improved and built upon to better suit the community’s wants and needs.

edited on Feb 21, 2018 by Dolly Phiri

Claire Bushrod Aug 2, 2017

Hi Dolly, this was a really interesting take on the issue of access to health care and transport. It really works with the sense of community that exists in Malawi. This community focus could really benefit the success of this service. I agree with you that the hub is necessary as not many people in the communities around Blantyre have private phones, but I like have you've left the option open to scale the service and provide it to private phones once it has become established and once the community has greater access to private phones through the energy, agriculture and social consulting projects.

I do however have some questions about the hub.

Have you developed any ideas in relation to security around the hub. You say there will be tablets attached to the benches, and while this might stop any theft during the daytime while more people are around, I don't believe this is enough for the night time. Therefore hiring a security guard could be beneficial, however it would require paying a salary to them. Additionally, would you be paying the attendant or is it more of a volunteer position? Would they be medically trained? I believe it would be useful for the attendant to at least initially be medically trained as they could assist the first time users. Maybe once the service is established the attendant may not need as much medical training.

You suggested a 400 Kwacha fee for using the hub. Is this for every time they go to the hub or like a subscription fee. I think the latter is better, otherwise people will continue to walk to the free clinics and risk losing half a days pay.

The hub has the resources to track a patient's history. I think this is very important as it could help prevent fraud and drug abuse. You would need to create some kind of system for identifying when the patterns of use could be associated with either of these issues. It could then alert the attendant, or perhaps another doctor who could come and give a proper diagnosis to ensure truthfulness.

My last question is around medicine storage. How will that be organised? Medicines often need to be refrigerated so the hub will have to have constant access to electricity or a generator. As mentioned before there could be security issues around theft of medicine. How do you intend to combat that?

I hope these questions give you something to think about and help you further define your idea.

Reply 2

Dolly Phiri Aug 3, 2017

Hi Claire,

Thank you so much for your feedback.
In regards to security, yes the guard will have to be paid (there should ideally be one present day and night) and this ofcourse raises the operating costs of the hub but it is essential for the success of the hub as possession theft is a huge issue. The attendant again is another cost, they would not have to be medically trained, the app would be doing most of the work and their role is basically to facilitate use of the app and issue the medication. This improves the employment rate in the community which is a social benefit but potentially, I also thought as there is danger in having a non-medically trained individual issuing medications, they could be issued via vending machine so medication can be accessed both day and night as well. This should answer the refrigeration question. However, in regards to electricity, I think that is why it is so vital to work together with the other teams, especially Energy and the solution that they come up with could combat this issue.

I do think the subscription idea is excellent, it lowers the costs on the part of the villagers but that recurring income is good for the business as we are always guaranteed income.

Reply 1

(Account removed) Aug 2, 2017

Adding on to the questions previously asked. As we experienced, electricity supply in Malawi is unreliable and in many parts non-existant. Would you wait for a future where this is not an issue or consider integrating energy supply solutions such as solar power into the hub facilities?

Reply 3

Dolly Phiri Aug 3, 2017

Hey Gabby,

I actually think solar power would be the best solution! They wouldn't have to rely on ESCOM and it's more environmentally-friendly than using a diesel powered generator. Also, solar power guarantees a constant supply so that would be the initial energy source until the Energy team does come up with a more sustainable solution that could work with this.

Reply 1

Soni Lawson Aug 3, 2017

Dolly, I really enjoyed reading this. I like how you have made it is a communal hub and how it has the local language so its easy for villagers to understand. This idea can be useful in other projects as well which would benefit the communities. However i have a few questions how will you keep the maintenance up for this hub? Who will check if there is enough stock? How will you make sure it is secure?

I like the way this is headed and I would be keen to hear feedback about this because it is a great concept

Reply 2

Dolly Phiri Aug 5, 2017

Thanks Soni, I'm glad you like it. This idea is still quite preliminary so I haven't really thought about the logistics around maintenance yet. However I do think a local could be employed to do this and medications can be locally sourced because it is cheaper than importing. This raises costs but it also does empower the community by boosting employment which is socially beneficial. For security, it is discussed above that there would need to be a guard both day and night. Again, extra costs but this will be reduced when we reach an economy of scale.

Reply 0

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